Breast Cancer: Risk Factors, Symptoms and Nursing Management - HS 3201

This presentation delves into the comprehensive nursing care of breast cancer patients, using Mrs. Mary Lim's case as a focal point. It begins by discussing the risk factors and pathophysiology of breast cancer, differentiating between modifiable and non-modifiable elements and relating them to the patient's medical history. The presentation then explores the pathophysiology of symptoms experienced by Mrs. Lim, including nausea, vomiting, oral mucositis, loss of appetite, and fatigue, providing detailed explanations of their causes. Furthermore, it outlines the pharmacological and non-pharmacological management strategies for each symptom, supported by current evidence. The presentation also addresses the nursing management of Mrs. Lim receiving chemotherapy, focusing on nutritional and psychological aspects, offering interventions such as cognitive behavioral therapy, emotional coping strategies, and the importance of support groups. Overall, the presentation provides a well-rounded approach to breast cancer nursing, integrating both the physical and psychological dimensions of patient care.

HS 3201
Adult Nursing
[Breast Cancer]
Subgroup 2

Learning objectives
At the end of the lesson, student will be able to,
1) Discuss the risk factors and pathophysiology of breast cancer.
2a). Explain the pathophysiology of the symptoms experienced by Mrs Mary Lim.
2b). Discuss the management of each symptom experienced by Mrs Mary Lim.
3). Discuss the nursing management of Mrs Mary Lim receiving chemotherapy, in
particular, the nutritional and psychological aspects. Support your answers with

Mrs Mary Lim, a 34-year-old administration
officer, is recently diagnosed with stage IIA
cancer of the right breast. She underwent an
elective modified radical mastectomy with lymph
node dissection. She is currently undergoing the
fourth session of adjuvant chemotherapy. She
has been experiencing nausea continuously and
vomits following each dose of chemotherapy. She
complained of burning pain in her mouth due to
ulcers. She also complained of loss of appetite
and experiencing constant fatigue.
CHUA POH PING

Medical history
No past medical history
Family history
Sister died due to breast cancer at 45 years old.
Drug allergy
Paracetamol
Current medications
● PO Metoclopramide 10mg TDS
● PO Oxycontin 20mg BD
● PO Mist morphine 20mg 4H PRN (for breakthrough pain)
Social history
Married and has three children, two boys and one girl, aged four years, three years and one year old
CHUA POH PING

Definition of breast cancerCHUA POH PING
● A cancerous disease where cells located in the breast grow and multiply excessively at
uncontrollable rates. Cancerous growth across the breast tissues can occur at various parts,
primarily in the milk-producing lobules and in ducts which circulate milk to the nipples.
● Metastasis is the condition where this cancerous growth spread in areas outside the
breast.
(Centers for Disease Control and Prevention, 2019)
http://pleasesellthebruins.com/anatomy-of-a-breast-cancer/

Causes & Risk factors
of breast cancer.

Risk Factors: 2 types modifiable and non-modifiable risk factors of breast cancer
To identify the risk factors that patient have and correlate to the pathophysiology of
breast cancer. (From teacher sheet guidelines).

Causes of breast cancerCHUA POH PING
• Cancer grows when a cell’s DNA is damaged, but why or how that DNA becomes damaged is
still unknown.
• It could be genetic or environmental, or in most cases, a combination of the two.
(National Breast Cancer Foundation,2016)
https://www.nationalbreastcancer.org/breast-cancer-risk-factors

Non-Modifiable Risk factor of
breast cancer1. Age - Risk increases with aging (Brinton et al., 2019). At twenty years, development of breast cancer has a
chance of 0.6 percent. The chance becomes 3.84 percent at the age of seventy areas. At the age progresses and
especially after menopause.
2. Gender – ‘Breast cancer’ occurs hundred times more ‘commonly in women as compared to men. The cases of
male ‘breast cancer’ are generally detected when a man is aged between sixty and seventy.
CHUA POH PING

Non-Modifiable Risk factor of
breast cancer● Genetics – Family history and women carrying BRCA1, BRCA2 genes has
greater chances of having breast cancer.
● A history of breast cancer or breast lumps – women who has beginning
breast lumps have a high risk of developing a fully formed cancer in later
stages of life. High breast density leads to cancer
(Shiovitz and Korde, 2015; Rebbeck et al.,2015).
https://provimaging.com/genetic-
testing-breast-cancer/

Modifiable risk factor of breast
cancer● Estrogen exposure – women who are exposed to estrogen for a prolonged
span have increased chances of breast cancer.
● Body weight - Overweight or obese women following menopause have
greater risk of having breast cancer
(Hilakivi-Clarke et al.,
2017)
https://www.ithaca.edu/sacl/healthpromotion/
CHUA POH PING

modifiable risk factors of
breast cancer● Cigarette smoking – Smoking causes breast cancer in the premenopausal,
younger women. Passive smoking can lead to breast cancer in postmenopausal
women. This is an avoidable risk factor.
● Prolonged use of oral contraceptives – has been reported to cause breast
cancer as well. This is an avoidable risk factor.
(Terry & Rohan,2002; Huang,Warner & Gustafsson,2015)
CHUA POH PING
https://www.semanticscholar.org/paper/Risk-Factors-and-Preventions-of-Breast-Cancer-
Sun-Zhao/9c515baf0642dfd5191060a9a371d47e01f53e9f